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A nimble flexibility during a pandemic

Adirondack Health nurses have gone ‘above and beyond’ during pandemic, nurse officer says

Emily Daby, a nurse at Adirondack Health, stands at a station where she monitors patients’ vital signs as they come through the ambulatory surgery unit. She’s the first person people see when they come out from under general anesthesia, but they don’t usually remember her. “We still have good conversations,” Daby said on May 5. “They just don’t remember them.” Daby has worked at Adirondack Health for 20 years. (Enterprise photo — Aaron Cerbone)

SARANAC LAKE — Adirondack Health has been celebrating its staff, nurses and medical professionals this week as it recognizes both national Nurse Appreciation Week and Public Health Week with barbecues, contests and awards. The theme for the week is “Rolling Out the Red Carpet.”

Chief Nursing Officer Dave Mader said the nurses he oversees at the hospital are truly “heroes.” There are between 165 and 200 nurses at Adirondack Health, he said. Nursing is a broad profession. At Adirondack Medical Center, they do in-patient acute care. There are also nurses at Adirondack Health primary care clinics and the Lake Placid Health Center, as well as long-term care nurses at Mercy Living Center in Tupper Lake.

“Here, the nurses, we do a little bit of everything,” Mader said.

That includes work outside of their job descriptions.

“‘That’s not my job,’ is not something that you hear a lot,” Adirondack Health Spokesman Matt Scollin said.

Their job descriptions have been stretched further than ever before during the coronavirus pandemic, he added.

Mader said the local and international public has given the whole health care field “tremendous recognition” during the pandemic. He said this is well-deserved recognition, because nurses “stepped up” to meet the community’s needs.

“‘Impressive and heroic’ are the two words that come to mind, just exceeding all expectations,” Mader said. “It’s been a long two years for sure.”

When the pandemic hit, nurses started doing the daily COVID-19 symptom screenings for hospital staff, patients and vendors as required, closed Mercy off on a dime to insulate its elderly residents from the virus and got a COVID-19 testing clinic up and running in a day. Testing at the hospital’s “COVID cabin” still happens seven days a week.

As the pandemic and the medical response to COVID-19 evolved, nurses have taken on more and more duties — conducting tests, administering vaccines, treatments and preventative drugs.

When preventative drugs got federal approval, Scollin said Adirondack Health employees were tasked with getting them to people at risk of serious sickness if they contracted the virus before hospitals in Albany were able to. It’s not a competition, he said, but he said this is a sign of how “nimble” the nurses at Adirondack Health are.

AMC was one of the last hospitals in the state to get vaccine doses when they were first released around Christmas in 2020, but mere weeks later, the hospital was praised by New York’s governor for its speedy distribution of doses. Adirondack Health was the fourth-fastest health organization in the state in vaccine distribution at the time.

Mader said this was only because of the dedication of the nursing staff, who were working around the clock during the holidays.

The hospital has never had dedicated staff for its vaccine or testing clinics, Mader said. All the work to get more than 3,500 doses in people’s arms in the past year-and-a-half was done on overtime. Nurses just folded the work into their daily jobs.

Salaried nurse leaders just did extra work for no extra pay.

Adirondack Health eventually began offering $50 bonuses for those willing to work extra four-hour stints in the cabin.

Mader said some nurses were working seven days a week when vaccine clinics started en masse, dedicating their weekends and evenings to getting people vaccinated.

“They did what needed to be done,” Mader said.

Mader said Adirondack Health billed these hours separately to track the number of COVID-related hours staff work. According to data provided by Scollin, as of April 24, nurses had worked approximately 51,582 extra hours in the past year because of the pandemic. That’s equivalent to 2,149 days.

Lots of people were eager to get the vaccine when it was released, but the state had a tiered list of who could get it first. People working in contact with COVID-positive patients were prioritized — including Adirondack Health staff.

Some of the vaccine vials held 10 doses each and they expired pretty fast. Once a vial was opened, if a dose wasn’t used that day, it had to be trashed and would be wasted. At the end of a day, if they had doses left after vaccinating their coworkers, Mader said nurses went “above and beyond” to call people next in line in to get their shot, using personal contacts in the community to bring in teachers, direct care providers and other people qualifying for the next wave.

They called in first responders, staff at the state Office for People With Developmental Disabilities, Citizen Advocates and St. Joseph’s Addiction Treatment and Recovery Centers to get their vaccines.

Scollin said they never wanted to have to tell the state Department of Health “we dumped one down the drain.”

Assistant Vice President of Critical Care Services Carrie Reardon organized a lot of the vaccine distribution, Mader said, and has been working long hours during the pandemic to meet the community’s needs. He said her tireless work has earned her the moniker “Mrs. COVID.”

When a group of international students on J-1 work visas needed to be tested, she met them outside a hotel in Lake Placid.

The hospital’s COVID clinic had a phone for people to call with questions.

“The phone, literally, if you hung up the phone, it would ring,” Mader said.

Scollin said in the evenings, that line was forwarded to a cell phone so anyone around at the hospital could pick up and answer questions, alleviate concerns and talk people through their exposures.

“I found out weeks after it happened that Carrie had been taking that phone home and sleeping with it on her nightstand,” Scollin said.

When it rang, she’d pick up, no matter the time.

Before the counties picked up the role of calling people who tested positive, she did it.

Because Reardon was so involved in the virus testing, Mader said she developed a large mental map of the community and who had tested positive, to the point where he said she could accurately predict who would test positive next.

He said she’s connected to the community through the school, youth sports and her circles of friends, so she knew many of the familial connections in town and who would have been exposed.

Scollin said that sort of knowledge can’t be put into an algorithm. He said you can’t find that skillset just anywhere.

But, they also knew because she wanted to be so involved, they had to make sure she could disconnect.

Mader said when she goes on vacation, they keep the book of positive tests so she can’t take it with her.

When elective surgeries were ordered to stop for several weeks in 2020, the vast majority of hospitals in the state and country had mandatory furloughs, Mader said, but Adirondack Health did not.

“I’m so proud of our organization, too, because we did not furlough anybody,” Mader said.

Adirondack Health offered voluntary furloughs, which some staff took them up on.

“It’s not like we got lucky either,” Scollin said. “It was a conscious decision we made at the beginning to say, ‘We’re not going to furlough people.'”

Instead, the hospital put them to work in other areas, running COVID-related units or assisting other staff with their increasing duties. At the time, there was no guaranteed federal reimbursement for keeping all their staff active.

“We had to commit as an organization that we’re probably going to take a hell of a financial hit that year,” Mader said.

Scollin said they knew the CARES Act would have trillions of dollars in coronavirus aid funding, but at the time, they didn’t know what piece Adirondack Health would get.

Mader found it admirable how flexible the nurses were.

He said there were OR nurses, like Leslie Lindsay, who hadn’t been out of the operating room in years. He said she told him she loved moving to long-term care for elderly residents at Mercy — walking little old ladies and gentlement to the bathroom, bringing them lunch trays and talking with them.

“I had never seen her so light,” Mader said. “She was like, ‘Oh my God, it took 10 years off my career. The patients are so appreciative.'”

This was an unexpected surprise for all of them, he said, and he believes shifting around to new positions may have helped some nurses stave off burnout.

Emily Daby has worked at Adirondack Health for 20 years and currently is a nurse in the ambulatory unit, a recovery unit for walk-in-walk-out surgeries. When these surgeries got put on hold in 2020, she had to move to new units. She said she enjoyed the change.

“I like learning new things,” Daby said. “Each time you go to a new department you learn a different way to be a nurse. It keeps your mind fresh and it’s exciting.

“I love it. I’m really glad that I work here,” she said. “I have wonderful co-workers. I have a lot of support from our nursing management.”

When there was a recent COVID-19 outbreak at a Sunmount community building on Haymeadow Drive in Tupper Lake, Jepper Devlin, a nurse at AMC, gave up the portion of her day she was supposed to be on break to give the developmentally disabled residents injections of the antiviral remdesivir treatment. Each treatment took hours.

Mader said it is these selfless acts that he sees “over and over again” which makes him so impressed with Adirondack Health’s nurses.

On Tuesday and Wednesday, Adirondack Health awarded employees with distinctions for their hard work, including several for the health care organization’s peer-nominated Florence Nightingale Award.

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